LAS VEGAS—The use of virtual reality and virtual reality hypnosis provides an analgesic effect, reducing pain and anxiety in patients with burns, for example, who describe pain during wound care as “severe to excruciating.”David R. Patterson, PhD, a Professor in the Department of Rehabilitation Medicine at the University Washington, Seattle, provided an overview of virtual reality distraction, the combination of virtual reality distraction hypnosis, and virtual reality hypnosis in the management of patients with pain.One study of 11 hospitalized patients at a major regional burn center who had their burn wounds debrided and dressed while partially submerged in a hydrotherapy tank found they reported significantly less pain when distracted with virtual reality. Each patient spent 3 minutes of wound care with no distraction and 3 minutes of wound care in virtual reality during a single wound care session. While they were wearing a virtual reality helmet, they had a reduction in time spent thinking about pain, a reduction in pain unpleasantness, a reduction in worse pain—and an increase in fun.He explained the steps of virtual reality hypnosis. Following relaxation and instructions, patients appear to float down through a canyon, seeing the numbers 1 to 10. After appearing over a scenic lake, post-hypnotic suggestions are given and patients return up the canyon.Studies have shown virtual reality hypnosis works for burn pain (n=1 and n=13), chronic neuropathic pain (n=13), and trauma pain. In a case series in patients with burn pain being treated for their wounds—92% of whom were male, 92% Caucasian, 46% with a burn to the face and mean age, 38 years—use of virtual reality hypnosis reduced all measures of pain and anxiety. Specifically, there was a 29% decrease in the amount of time that patients were thinking about their pain and an 11% decrease in the unpleasantness of their wound care. Worst pain scores dropped 20% and anxiety, 26%. The amount of opiates required for wound care dropped by half from baseline to day 3 in both the patients with burns and with trauma pain.In a controlled study in 12 patients, virtual reality was also found to reduce pain during physical therapy for severe burns. One important question to ask, Dr. Patterson said, is whether virtual reality works when used over and over with the same patient; or, does the patient get bored with virtual reality?

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